No more satisfying story exists than the parable of the prodigal son, reformed from a wayward past and come home to rectitude and redemption. No more dismaying sequel could be imagined than one in which the prodigal falls off the wagon and returns to his errant ways.
Yet that is the scenario we are getting with the recent proposal from Governor Don Sundquist to “reform” TennCare, the state-run medical program for Tennessee’s uninsured and uninsurables.
Since its inception in the second term of former Governor Ned McWherter, TennCare has functioned as a model, however imperfect, of a state’s concern for its citizens — an improvement over the bureaucratic federal system of Medicaid, which it replaced through a waiver granted under the administration of former President Clinton.
Now Sundquist, who has been a champion of TennCare for the last several years, is seeking a new federal waiver for a watered-down version of TennCare which would provide less care for fewer citizens — notably large numbers of uninsurables who would be sliced from the program’s rolls. It is no secret that all this was offered as a sop to the opponents of Sundquist’s various tax-reform plans in the hope that these naysayers would see the governor as cost-conscious and thereby, as if by magic, relent in their obstructionism.
This strategy was unfortunate enough, but, when a federal judge blocked the waiver at the request of protesting health-care advocates, Sundquist became miffed and threatened to junk TennCare altogether. A prodigal act indeed.
The governor himself — who transcended his traditionalist conservative background several years ago to become a proponent of a state income tax and other progressive concepts — has made the point in the past that Tennessee is better off financially with TennCare as it was initially conceived than it would be with Medicaid. Plagued as the state’s program has been with mounting costs and inefficient provider organizations, TennCare is still less of a financial burden on the state and its citizens than the federal program by itself would be.
One of the problems with Sundquist’s proposed restructuring is that not only would it cruelly expunge too many people — mainly those with prior illness who have no hope of gaining private insurance — it would also deny the state significant infusions in the way of federal matching funds.
This is one of those cases of simple arithmetic in which less is less.
We urge the governor to repress his less than commendable reaction to the judicial ruling and to forgo pushing ahead with his ill-advised restructuring of TennCare. We sympathize with a chief executive who has seen his tax-reform plans frustrated by mossback members of his own Republican Party and by opportunistic Democrats. But in this case the proposed solution, the gutting of TennCare, would not only be a bad end in itself, it is almost surely destined to fail as a concession to the professional government-bashers and ax-the-taxers, who in July conjured up a bona fide riot to sabotage tax reform and have indicated that they will continue to oppose it for the foreseeable future.
Better to see to our duty toward the uninsurables than to pander to this benighted lot.
